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"Fast Track" AND "Emergency"

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https://www.readbyqxmd.com/read/30093379/interventions-to-improve-patient-flow-in-emergency-departments-an-umbrella-review
#1
Loren De Freitas, Steve Goodacre, Rachel O'Hara, Praveen Thokala, Seetharaman Hariharan
OBJECTIVES: Patient flow and crowding are two major issues in ED service improvement. A substantial amount of literature exists on the interventions to improve patient flow and crowding, making it difficult for policymakers, managers and clinicians to be familiar with all the available literature and identify which interventions are supported by the evidence. This umbrella review provides a comprehensive analysis of the evidence from existing quantitative systematic reviews on the interventions that improve patient flow in EDs...
August 9, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/30086613/recent-research-trends-and-updates-on-nonalcoholic-fatty-liver-disease
#2
Jeong-Ju Yoo, Won Kim, Moon Young Kim, Dae Won Jun, Sang Gyune Kim, Jong-Eun Yeon, Jin Woo Lee, Yong Kyun Cho, Sang Hoon Park, Joo Hyun Sohn
Nonalcoholic fatty liver disease (NAFLD), together with metabolic syndrome and obesity, has shown a rapid increase in prevalence worldwide and is emerging as a major cause of chronic liver disease and liver transplantation. Among the various phenotypes of NAFLD, nonalcoholic steatohepatitis (NASH) is highly likely to progress to development of end-stage liver disease and cardiometabolic disease, resulting in liver-related and non-liver-related mortality. Nonetheless, there is no standardized pharmacotherapy against NASH and many drugs are under development in ongoing clinical trials...
August 8, 2018: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/30078854/comparison-of-bispectral-index-and-end-tidal-anaesthetic-concentration-monitoring-on-recovery-profile-of-desflurane-in-patients-undergoing-lumbar-spine-surgery
#3
R Sudhakaran, Jeetinder K Makkar, Divya Jain, Jyotsna Wig, R Chabra
Background and Aims: Several techniques have evolved over time to monitor depth of anesthesia and ensure enhanced recovery. This randomized double-blinded trial was designed to compare bispectral index (BIS) or end-tidal anaesthetic concentration (ETAC) monitoring on the recovery characteristics of patients undergoing thoracolumbar spine surgeries. Methods: Seventy American Society of Anesthesiologist I-II patients of either sex were randomized to Group B - BIS-guided protocol, Group E - ETAC-guided protocol, or Group S - Standard protocol...
July 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30059375/interdisciplinary-design-to-improve-fast-track-in-the-emergency-department
#4
Carol Anne Celona, Andrew Amaranto, Robin Ferrer, Matt Wieland, Stacy Abrams, Farley Obusan, Sharon LoPuzzo, Valsamma Joy
Delays in medical care will increase risks for patients. For this reason, timeliness of care is a public health priority and the one of the missions for this facility. The goal of this process improvement project was to enhance timeliness of care by restructuring fast track. Door-to-provider time, treat and release time, and the number of patients who left without being seen by a provider were monitored. Nurse practitioners were introduced into advanced practice provider mix and the development of care teams was implemented...
July 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/30021751/patient-tailored-triage-decisions-by-anaesthesiologist-staffed-prehospital-critical-care-teams-a-retrospective-descriptive-study
#5
Morten Langfeldt Friberg, Leif Rognås
OBJECTIVES: The primary objective was to estimate the incidence of patients in the Central Denmark Region triaged to bypass the local emergency department without being part of a predefined fast-track protocol. The secondary objective was to describe these triage decisions in more detail with regard to the most common diagnoses, incidence of direct referral sorted by the prehospital critical care team (PHCCT) and the destination hospital. DESIGN: Retrospective descriptive study...
July 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/29977239/the-us-military-commitment-to-vaccine-development-a-century-of-successes-and-challenges
#6
REVIEW
Silvia Ratto-Kim, In-Kyu Yoon, Robert M Paris, Jean-Louis Excler, Jerome H Kim, Robert J O'Connell
The US military has been a leading proponent of vaccine development since its founding. General George Washington ordered the entire American army to be variolated against smallpox after recognizing the serious threat that it posed to military operations. He did this on the recommendation from Dr. John Morgan, the physician-in-chief of the American army, who wrote a treatise on variolation in 1776. Although cases of smallpox still occurred, they were far fewer than expected, and it is believed that the vaccination program contributed to victory in the War of Independence...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29953101/-fast-track-rehabilitation-in-perforated-duodenal-ulcer
#7
A I Khripun, I V Sazhin, S N Shurygin, G B Makhuova
AIM: To analyze the outcomes of fast track rehabilitation program in patients with perforated duodenal ulcer (PDU). MATERIAL AND METHODS: For the period 2013-2016 at the Department of Surgery and Endoscopy 206 PDU patients have been treated. Inclusion criterion for the main group (n=77) was duodenal ulcers, their dimension up to 1 cm, laparoscopic suture of perforated ulcer, fast track rehabilitation program implementation. The control group consisted of 129 patients who underwent open suturing of perforated ulcer followed by conventional treatment in postoperative period...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29929886/the-experiences-of-pre-and-in-hospital-care-in-patients-with-hip-fractures-a-study-based-on-critical-incidents
#8
Bodil Ivarsson, Ami Hommel, Magnus Sandberg, Desirée Sjöstrand, Anders Johansson
BACKGROUND: Hip fractures are described to have a significant impact on patients' well-being and different fast-track concepts could result in a reduction of the patient's psychological and emotional reactions before pre- and intrahospital care. AIMS AND OBJECTIVES: This study aimed to elucidate perceived situations of significance experienced by patients with hip fracture during the prehospital- and in-hospital care. DESIGN: The study used a qualitative approach using a critical incident technique (CIT), 14 patients with hip fractures were included...
August 2018: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/29905758/short-stay-unit-hospitalisation-vs-standard-care-outcomes-in-older-internal-medicine-patients-a-randomised-clinical-trial
#9
Camilla Strøm, Lars Simon Rasmussen, Anne-Sophie Löwe, Anne Kathrine Lorentzen, Nicolai Lohse, Kim Hvid Benn Madsen, Søren Wistisen Rasmussen, Thomas Andersen Schmidt
Background: the effect of hospitalisation in emergency department-based short-stay units (SSUs) has not been studied in older patients. We compared SSU hospitalisation with standard care at an Internal Medicine Department (IMD) in acutely admitted older internal medicine patients. Methods: pragmatic randomised clinical trial. We randomly assigned patients aged 75 years or older, acutely admitted for an internal medicine disease and assessed to be suitable for SSU hospitalisation to SSU hospitalisation or IMD hospitalisation...
June 13, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29847313/exploring-and-improving-student-engagement-in-an-accelerated-undergraduate-nursing-program-through-a-mentoring-partnership-an-action-research-study
#10
Marguerite Bramble, Hazel Maxwell, Rochelle Einboden, Sally Farington, Richard Say, Chin Liang Beh, Grace Stankiewicz, Graham Munro, Esther Marembo, Greg Rickard
This Participatory Action Research (PAR) project aimed to engage students from an accelerated 'fast track' nursing program in a mentoring collaboration, using an interdisciplinary partnership intervention with a group of academics. Student participants represented the disciplines of nursing and paramedicine with a high proportion of culturally and linguistically diverse (CALD) students. Nine student mentors were recruited and paired with academics for a three-month 'mentorship partnership' intervention. Data from two pre-intervention workshops and a post-intervention workshop were coded in NVivo11 using thematic analysis...
May 30, 2018: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/29751212/sustainable-vaccine-development-a-vaccine-manufacturer-s-perspective
#11
REVIEW
Rino Rappuoli, Emmanuel Hanon
Vaccination remains the most cost-effective public health intervention after clean water, and the benefits impressively outweigh the costs. The efforts needed to fulfill the steadily growing demands for next-generation and novel vaccines designed for emerging pathogens and new indications are only realizable in a sustainable business model. Vaccine development can be fast-tracked through strengthening international collaborations, and the continuous innovation of technologies to accelerate their design, development, and manufacturing...
May 8, 2018: Current Opinion in Immunology
https://www.readbyqxmd.com/read/29742626/delta-alert-expanding-gerotrauma-criteria-to-improve-patient-outcomes-a-2-year-study
#12
Lynn L Wiles, Mark D Day
BACKGROUND/SIGNIFICANCE: Because of their decreased physical reserve and increased risk of complications, the geriatric trauma patient (GTP) population warrants heightened awareness by clinical staff. PURPOSE: The purpose of this study is to determine whether the institution of a third-tier trauma protocol results in a change in GTP outcomes, complications, and mortality rates. METHODS: Researchers conducted a retrospective review of 2 years of data from the trauma registry, hospital quality improvement audits, and patient charts to examine what, if any, patient outcomes were impacted by the institution of the expanded GTP protocol...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29738285/futsal-task-constraints-promote-transfer-of-passing-skill-to-soccer-task-constraints
#13
Luca Oppici, Derek Panchuk, Fabio Rubens Serpiello, Damian Farrow
This study investigated how learning a passing skill with futsal or soccer task constraints influenced transfer to a new task. Futsal (n = 24, 13.6 ± 1.2 years old, 7.0 ± 1.6 years of experience) and soccer (n = 24, 13.6 ± 1.2 years old, 6.8 ± 1.2 years of experience) players performed two 5v5 + goalkeeper modified games - a futsal-like task (small playing area with the futsal ball) and soccer-like task (large playing area with the soccer ball). Participants' passing accuracy and their orientation of attention were assessed during the two tasks...
May 8, 2018: European Journal of Sport Science
https://www.readbyqxmd.com/read/29608170/multiplexed-isothermal-amplification-based-diagnostic-platform-to-detect-zika-chikungunya-and-dengue-1
#14
Ozlem Yaren, Barry W Alto, Kevin M Bradley, Patricia Moussatche, Lyudmyla Glushakova, Steven A Benner
Zika, dengue, and chikungunya viruses are transmitted by mosquitoes, causing diseases with similar patient symptoms. However, they have different downstream patient-to-patient transmission potentials, and require very different patient treatments. Thus, recent Zika outbreaks make it urgent to develop tools that rapidly discriminate these viruses in patients and trapped mosquitoes, to select the correct patient treatment, and to understand and manage their epidemiology in real time. Unfortunately, current diagnostic tests, including those receiving 2016 emergency use authorizations and fast-track status, detect viral RNA by reverse transcription polymerase chain reaction (RT-PCR), which requires instrumentation, trained users, and considerable sample preparation...
March 13, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29569844/why-do-fast-track-patients-stay-more-than-four-hours-in-the-emergency-department-an-investigation-of-factors-that-predict-length-of-stay
#15
Stephen D Gill, Stephen E Lane, Michael Sheridan, Elizabeth Ellis, Darren Smith, Julian Stella
OBJECTIVE: Low-acuity 'fast track' patients represent a large portion of Australian EDs' workload and must be managed efficiently to meet the National Emergency Access Target. The current study determined the relative importance and estimated marginal effects of patient and system-related variables in predicting ED fast track patients who stayed longer than 4 h in the ED. METHODS: Data for ED presentations between 1 July 2014 and 30 June 2015 were collected from a large regional Australian public hospital...
March 23, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29545578/exploring-ugi-azide-four-component-reaction-products-for-broad-spectrum-influenza-antivirals-with-a-high-genetic-barrier-to-drug-resistance
#16
Jiantao Zhang, Yanmei Hu, Christopher Foley, Yuanxiang Wang, Rami Musharrafieh, Shuting Xu, Yongtao Zhang, Chunlong Ma, Christopher Hulme, Jun Wang
Influenza viruses are respiratory pathogens that are responsible for seasonal influenza and sporadic influenza pandemic. The therapeutic efficacy of current influenza vaccines and small molecule antiviral drugs is limited due to the emergence of multidrug-resistant influenza viruses. In response to the urgent need for the next generation of influenza antivirals, we utilized a fast-track drug discovery platform by exploring multi-component reaction products for antiviral drug candidates. Specifically, molecular docking was applied to screen a small molecule library derived from the Ugi-azide four-component reaction methodology for inhibitors that target the influenza polymerase PAC -PB1N interactions...
March 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29545502/accelerated-route-into-a-career-in-emergency-and-critical-care
#17
(no author information available yet)
Vets Now has launched a new fast-track induction programme for vets who want to work in emergency and critical care medicine. Clinical director Amanda Boag describes what's involved.
March 17, 2018: Veterinary Record
https://www.readbyqxmd.com/read/29499151/organs-on-a-chip-a-fast-track-for-engineered-human-tissues-in-drug-development
#18
REVIEW
Kacey Ronaldson-Bouchard, Gordana Vunjak-Novakovic
Organs-on-a-chip (OOCs) are miniature tissues and organs grown in vitro that enable modeling of human physiology and disease. The technology has emerged from converging advances in tissue engineering, semiconductor fabrication, and human cell sourcing. Encompassing innovations in human stem cell technology, OOCs offer a promising approach to emulate human patho/physiology in vitro, and address limitations of current cell and animal models. Here, we review the design considerations for single and multi-organ OOCs, discuss remaining challenges, and highlight the potential impact of OOCs as a fast-track opportunity for tissue engineering to advance drug development and precision medicine...
March 1, 2018: Cell Stem Cell
https://www.readbyqxmd.com/read/29482544/reducing-time-to-unit-among-patients-referred-to-an-outpatient-stroke-assessment-unit-with-a-novel-triage-process-a-prospective-cohort-study
#19
Maximilian B Bibok, Kristine Votova, Robert F Balshaw, Mary L Lesperance, Nicole S Croteau, Anurag Trivedi, Jaclyn Morrison, Colin Sedgwick, Andrew M Penn
BACKGROUND: To evaluate the performance of a novel triage system for Transient Ischemic Attack (TIA) units built upon an existent clinical prediction rule (CPR) to reduce time to unit arrival, relative to the time of symptom onset, for true TIA and minor stroke patients. Differentiating between true and false TIA/minor stroke cases (mimics) is necessary for effective triage as medical intervention for true TIA/minor stroke is time-sensitive and TIA unit spots are a finite resource. METHODS: Prospective cohort study design utilizing patient referral data and TIA unit arrival times from a regional fast-track TIA unit on Vancouver Island, Canada, accepting referrals from emergency departments (ED) and general practice (GP)...
February 27, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29454714/interphysician-differences-in-emergency-department-length-of-stay
#20
Stephen J Traub, Soroush Saghafian, Kurtis Judson, Christopher Russi, Bo Madsen, Stephen Cha, Hannah C Tolson, Leon D Sanchez, Jesse M Pines
BACKGROUND: Emergency physicians differ in many ways with respect to practice. One area in which interphysician practice differences are not well characterized is emergency department (ED) length of stay (LOS). OBJECTIVE: To describe how ED LOS differs among physicians. METHODS: We performed a 3-year, five-ED retrospective study of non-fast-track visits evaluated primarily by physicians. We report each provider's observed LOS, as well as each provider's ratio of observed LOS/expected LOS (LOSO/E ); we determined expected LOS based on site average adjusted for the patient characteristics of age, gender, acuity, and disposition status, as well as the time characteristics of shift, day of week, season, and calendar year...
May 2018: Journal of Emergency Medicine
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